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二氧化碳、接触式钕:钇铝石榴石及二氧化碳-钕:钇铝石榴石联合激光束对兔气管的伤口愈合及软组织影响

Wound healing and soft tissue effects of CO2, contact Nd: YAG and combined CO2-Nd: YAG laser beams on rabbit trachea.

作者信息

Laranne J, Lagerstedt A, Pukander J, Rantala I

机构信息

Department of Otorhinolaryngology, Medical School, University of Tampere, Finland.

出版信息

Acta Otolaryngol. 1997 Nov;117(6):909-17. doi: 10.3109/00016489709114223.

Abstract

Rabbit trachea was used as an experimental model to study tissue effects and healing of full-thickness tracheal lesions produced by CO2, contact Nd: YAG and combined, coaxial CO2-Nd: YAG (Combo) laser beams. Two power settings (10 W and 16 W) were used with CO2 and contact Nd: YAG lasers. Three different CO2/Nd:YAG power ratios (1:1, 1:2 and 1:4) and power settings (12 W 15 W and 16 W) were used with the Combolaser. Histological specimens for light and transmission electron microscopy were prepared immediately and 1, 3, 5, 7, 14 and 21 days postoperatively. The wound with the most precise and fastest healing was produced by contact Nd: YAG laser. CO2 laser produced a moderate amount of charring and the largest amount of coagulated tissue with a slightly prolonged healing period. In the acute phase, tissue defects produced by the Combolaser with power ratios 1:1 and 1:2 resembled the CO2 laser lesions but with slightly less charring. The power ratio 1:4 diminished the cutting properties of the beam considerably. During the healing period the Combolaser produced the most intensive inflammation and granulation tissue formation resulting in delayed regeneration of the lesion. In transmission electron micrographs the most severe damage to chondrocytes was seen after using the Combolaser. These findings indicate that the Combolaser produces deeper tissue damage than CO2 or contact Nd:YAG laser. However, the Combolaser appears to be suitable for tracheobronchial operations, owing to its good simultaneous cutting and haemostatic properties.

摘要

采用兔气管作为实验模型,研究二氧化碳激光、接触式钕:钇铝石榴石激光以及联合同轴二氧化碳 - 钕:钇铝石榴石(Combo)激光束产生的全层气管损伤的组织效应和愈合情况。二氧化碳激光和接触式钕:钇铝石榴石激光使用了两种功率设置(10瓦和16瓦)。Combo激光使用了三种不同的二氧化碳/钕:钇铝石榴石功率比(1:1、1:2和1:4)以及功率设置(12瓦、15瓦和16瓦)。术后即刻以及术后1、3、5、7、14和21天制备用于光镜和透射电镜检查的组织学标本。接触式钕:钇铝石榴石激光产生的伤口愈合最精确且最快。二氧化碳激光产生了适量的炭化以及最大量的凝固组织,愈合期略有延长。在急性期,功率比为1:1和1:2的Combo激光产生的组织缺损类似于二氧化碳激光损伤,但炭化略少。功率比1:4显著降低了激光束的切割性能。在愈合期,Combo激光产生了最强烈的炎症和肉芽组织形成,导致损伤的再生延迟。在透射电子显微镜照片中,使用Combo激光后可见对软骨细胞的最严重损伤。这些发现表明,Combo激光比二氧化碳激光或接触式钕:钇铝石榴石激光产生更深的组织损伤。然而,由于其良好的同时切割和止血性能,Combo激光似乎适用于气管支气管手术。

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